CTX-M Type Extended Spectrum β-Lactamases in Escherichia coli Isolates From Community Acquired Upper Urinary Tract Infections at a University in the European Part of Turkey

Çelik, Aygül Doğan; Yuluğkural, Zerrin; Kuloğlu, Figen; Eroğlu, Cafer; Torol, Sinem; Vahaboğlu, Haluk; Akata, Filiz

doi:10.1016/s1684-1182(10)60026-6

Cited by 14 publications

(13 citation statements)

References 14 publications

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“…Only at the level of academic research at the Universities, this subject is recently under study. In comparison with neighboring countries, this high percent of ESBL production noted in this study, is in agreement with what is found in Iran where 56% [21] of E. coli isolates were ESBL producers, and in Turkey where 74.6% [22] of E. coli isolates from hospitalized patients, and 36.7% of isolates from outpatients [23] were ESBL producers. While it is higher than that noted in Arab Gulf countries, such as Saudi Arabia [24] and Kuwait [25] (10% and 26% of hospital isolates, respectively, and 4% and 12% of community isolates, respectively).…”

Section: Discussionsupporting

confidence: 91%

Phenotypic and genotypic comparison of ESBL production by Vaginal Escherichia coli isolates from pregnant and non-pregnant women

Al-Mayahie

2013

Ann Clin Microbiol Antimicrob

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BackgroundVaginal Escherichia coli is a reservoir along the fecal-vaginal-urinary/neonatal course of transmission in extraintestinal E. coli infections. They also causes genital tract infections especially vaginitis, so that detection of their antibiotic resistance is an important approach to control these infections. One important mechanism of resistance is ESBL production by Enterobacteriaceae especially Klebsiella spp. and Escherichia coli, which is now a worldwide problem that limits therapeutic options.MethodsSixty one vaginal E. coli isolates from pregnant and non-pregnant women, were detected phenotypically and genotypically for ESBL production.ResultsMost of pregnant and non-pregnant women's isolates, were resistant to cefotaxime (100% vs. 81.5%, respectively) and more than half of them to ceftazidime (56.5% vs. 71.0%, respectively). One hundred percent each, 52.1% vs. 68.4%, and 73.9% vs. 60.5%%, were ESBL producers by screening, confirmatory, and PCR tests, respectively. Pregnant women's isolates had: CTX-M- (69.5%), SHV- and OXA-type (each 4.3%) ESBLs. Only one isolate (4.3%) had two types of ESBLs. All 16 CTX-M-positive (100%) isolates had CTX-M-1. Non-pregnant women's isolates were predominated by SHV and CTX-M -type (44.7% vs. 39.4%, respectively), followed by OXA- (15.7%), and TEM-type (2.6%). Of these isolates, 42.1% had two types of ESBL genes. All 15 CTX-M-positive (100%) isolates had CTX-M-1. Pregnant and non-pregnant women's isolates differed significantly (P≤ 0.05) regarding the expression of SHV- (4.3% vs. 44.7%, respectively) and CTX-M-type (69.5% vs. 39.4%, respectively) ESBLs. In both, CTX-M-1 was the predominant CTX-M group (each 100%). All of the isolates were susceptible to imipenem and meropenem, while the highest rate of resistance was against β-lactams. Multidrug resistance was noted in 56.2% of ESBL-producing isolates.ConclusionsGgenital tracts of pregnant and non-pregnant women represent different environments for propagation of ESBL-producing E. coli. In Iraq, nationwide study is required to make a precise estimation of this widespread of ESBL-producing bacteria.

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Section: Discussionsupporting

confidence: 91%

Phenotypic and genotypic comparison of ESBL production by Vaginal Escherichia coli isolates from pregnant and non-pregnant women

Al-Mayahie

2013

Ann Clin Microbiol Antimicrob

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“…Our results revealed that the ESBL-producing E. coli rate was 50.5% in patients with community-onset UTI, and 63.6% of ESBL (+) patients were diagnosed as having healthcare-associated UTIs, while only 29% of ESBL (-) patients had healthcare-associated UTIs. This prevalence seems to be higher than in previous studies [3,14]. In a study from Turkey, the SMART study, the rate of ESBLpositive E. coli was much higher in healthcare-associated than community-acquired UTIs during 2011 and 2012, at 50% and 38%, respectively [14].…”

Section: Discussionmentioning

confidence: 65%

Risk factors for community-onset urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli

Tuzun¹,

Kutlu²,

Kutlu³

et al. 2019

Turk J Med Sci

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IntroductionUrinary tract infections (UTIs) are the most common community-onset infections in the adult population in many parts of the world. Clinical manifestations of community-onset UTIs range from asymptomatic bacteriuria to acute pyelonephritis with sepsis [1,2]. The major UTI pathogen is Escherichia coli, and there is increasing multidrug resistance in the isolates from community-onset infections. Multidrug resistance of these isolates is frequently associated with the presence of extended-spectrum β-lactamase (ESBL) genes [3,4]. ESBL-producing isolates are resistant to all penicillins, cephalosporins, and aztreonam, combined with high resistance rates to fluoroquinolones and trimethoprim/ sulfamethoxazole (TMP-SMX) [5]. Multidrug resistance of ESBL-positive E. coli makes it more difficult to decide the antibiotic treatment in community-onset UTI and increases the risk of treatment failure. Early initiation of appropriate empirical therapy reduces mortality, especially in life-threatening UTIs [6]. Therefore, a better understanding of the risk factors for community-onset UTIs caused by ESBL-positive E. coli will guide clinicians in choosing appropriate empirical therapy. Also, it will ensure that measures are taken to reduce risk factors for these resistant infections.For this reason, we aimed to determine the prevalence and risk factors for community-onset UTI caused by ESBL-producing E. coli. Materials and methods Study population and data collectionThis prospective cohort study was conducted between January 2012 and March 2014 in cases of communityonset UTI caused by E. coli. Demographic characteristics, Background/aim: Community-onset urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli have increased in many parts of the world. This study aimed to determine the prevalence and risk factors for communityonset UTI caused by ESBL-producing E. coli. Materials and methods:This prospective cohort study was conducted between January 2012 and March 2014 in cases of communityonset UTI caused by E. coli. Patients with UTI due to ESBL-producing E. coli and patients with UTI due to non-ESBL-producing E. coli were compared to identify risk factors for ESBL-producing E. coli in the community.Results: A total of 305 patients (116 males [46.4%]; mean age: 57.76 ± 18.06 years) were included in the study. Among these patients, 154 (50.5%) were infected with ESBL-producing E. coli. In multivariate analysis, the healthcare-associated UTI (odds ratio [OR]: 1.80; 95% confidence interval [

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“…For example, in a recent study in Saudi Arabia [24], 20.3% of UPEC isolates from hospitalized patients were ESBL producers. Reports from Egypt, Iran, and Turkey revealed that the distribution of ESBL-EC was 78.8% [25], 56% [26], and 36.7% [27], respectively. In a study that comprised 22 European countries for the period of 2004 to 2007, the rate of ESBL-EC was 9.8% [5], while in a more recent study, it varied from 2% to 8% [28].…”

Section: Discussionmentioning

confidence: 99%

Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance

Al-Mayahie

Kuriashy

2016

J Infect Dev Ctries

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Introduction: Extended-spectrum β-lactamase (ESBL)-producing strains of Enterobacteriaceae are considered to be emerging pathogens. They are a major problem in hospitalized as well as community-based patients. Major outbreaks involving ESBL strains have been reported from all over the world. Recurrent urinary tract infection (UTI) is one of the risk factors for infection with ESBL-producing E. coli in hospitalized and non-hospitalized patients. Methodology: Ninety-one E. coli isolates from outpatients with recurrent UTIs were surveyed phenotypically and genotypically for ESBL production and tested for antimicrobial susceptibility. Results: Of 91 E. coli isolates, 75.8% were resistant to each of cefotaxime and ceftazidime and 74.7% produced ESBLs. CTX-M-type was the most frequent ESBL (accounting for 70.3%), with CTX-M-1 being the only subtype possessed by these isolates. The prevalence of OXA-and SHV-type was 32.9% and 10.9%, respectively. None of the isolates produced TEM β-lactamase. All OXA-type ESBL were produced concomitantly with CTX-M1. Both ESBL producers and non-producers had high resistance to ampicillin followed by trimethoprimsulphamethoxazole, third-generation cephalosporins, and tetracycline. No isolate showed resistance to imipenem and meropenem. In total, resistance rates of ESBL producers were higher than those of ESBL non-producers, as was multidrug resistance (52.7% versus 8.7%, respectively). Conclusions: Our study documented high distribution of ESBLs among E. coli isolates from outpatients with recurrent UTIs, with CTX-M as the predominant ESBL. In the current situation, it is important that antibiotic treatment is be started only after a proper sensitivity report is obtained from the laboratory.

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CTX-M Type Extended Spectrum β-Lactamases in Escherichia coli Isolates From Community Acquired Upper Urinary Tract Infections at a University in the European Part of Turkey

Cited by 14 publications

References 14 publications

Phenotypic and genotypic comparison of ESBL production by Vaginal Escherichia coli isolates from pregnant and non-pregnant women

Phenotypic and genotypic comparison of ESBL production by Vaginal Escherichia coli isolates from pregnant and non-pregnant women

Risk factors for community-onset urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli

Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance

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